Continuous Improvement and the Expansion of Quality ... - NCQA

C H R o N I C D I S E A S E M A N A G E M E N T
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N AT I o N A l C o M M I T T E E f o R Q U A l I T y A S S U R A N C E
DISEASE MoDIfyING ANTI-RHEUMATIC DRUG
THERAPy IN RHEUMAToID ARTHRITIS
Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the immune system attacks
healthy joints. 1 It causes joint destruction, bone erosion and damage to muscles, kidneys and other
organs. 2 RA affects 1.5 million Americans. 3 The Disease Modifying Anti-Rheumatic Drug Therapy
(DMARD) in Rheumatoid Arthritis measure assesses whether RA patients receive medications that
slow the disease’s progression and help them maintain functional capacity longer.
• People with persistent RA are at greater risk
for premature death. 4 In particular, people
with RA die from heart-related problems at
higher rates than people without RA. 5
• Arthritis and other rheumatic conditions
are the most common causes of disability
in the United States. Approximately
850,000 adults reported being disabled by
RA—more than blindness, deafness, bone
fracture, cancer and diabetes combined. 6
• Although there is no cure for RA, DMARDs
may effectively protect joints and minimize
inflammation, slowing progression of the
disease and reducing pain. 7
the Case for Improvement
• Arthritis and related conditions, including
RA, cost the U.S. economy $128 billion
each year. Direct costs, like medical
expenses, are estimated at $81 billion,
and indirect costs, such as lost wages and
disability payments, are estimated at $47
billion. 8
• In 2009, RA was the principal diagnosis in
over 16,000 hospitalizations. on average,
each visit lasted 4 days and cost nearly
$36,000. 9
• Approximately 60 percent of people with
RA become too ill to work after 10 years of
the disease. 10
HEdIs Measure definition
The percentage of diagnosed adults with
rheumatoid arthritis who were dispensed
at least one ambulatory prescription for a
DMARD.